Ingabe ingane yakho inenkinga yokuphefumula? Ingabe ikhala layo lizwakala licijile? Ake sifunde ngeChoanal Atresia

Wake waphawula umehluko omncane endleleni ingane yakho esanda kuzalwa ephefumula ngayo ngenkathi uyibheka? Mhlawumbe iphefumula kahle uma ikhala, kodwa uma ilele futhi izolile, ingabe ibonakala inenkinga encane yokuphefumula ngekhala layo? Noma ingabe iyeka ukuncelisa ngoba iqhubeka nokuvula umlomo wayo ukuze iphefumule? Kuvamile ukuthi umama noma ubaba azizwe esaba kancane uma bebona izinto ezinjengalezi. Namuhla sizokhuluma ngesimo sokuzalwa esingadala izimpawu ezifanayo, kodwa esingaziwa kahle. Leso yi-'Choanal Atresia'.

Kalula nje, iyini i-Choanal Atresia?

I-Choanal Atresia (ebizwa ngokuthi: ko-a-nal atre-sia) yisimo lapho umntwana ezalwa evalekile ngemuva kwekhala lakhe, lapho lixhuma khona nomphimbo wakhe (obizwa ngokuthi i-choana), ngengxenye yolwelwesi noma ithambo. Cabanga ngekhala njengezindawo ezimbili, ezineminyango emibili ngemuva kwekamelo ngalinye elivalekile. Lokhu kuvaleka kungabangelwa yithambo, noma inhlanganisela yethambo nezicubu ezithambile.

Lesi simo singathinta ikhala elilodwa lomntwana (`Icala Elilodwa`) noma womabili amakhala (`Icala Elilodwa`). Ukuthi libi kangakanani nokuthi ukwelashwa kudingeka ngokushesha kangakanani kuncike ekutheni ukuvaleka kusehlangothini olulodwa noma zombili izinhlangothi, nokuthi likude kangakanani.

Yiziphi izinhlobo ezimbili eziyinhloko ze-Choanal Atresia?

Ake siqonde ngokucacile izinhlobo ezimbili eziyinhloko zalokhu. Kuzoba lula kuwe uma ukubheka etafuleni.

I-Choanal atresia yenzeka cishe koyedwa kwabayi-7,000 abazalwayo. Kulaba, abangaphezu kuka-60% bazalwa ngohlangothi olulodwa. Futhi kuvame kabili emantombazaneni kunabafana.

Ziyini izimpawu zalesi simo?

Izimpawu ziyahlukahluka kuye ngezinhlobo ezimbili esixoxe ngazo ekuqaleni.

Uma izinhlangothi zombili zekhala zivimbekile (Bilateral Choanal Atresia)

Odokotela bangazibona lezi zimpawu ngokushesha nje lapho umntwana ezalwa.

• Ubunzima obukhulu bokuphefumula: Ingane inenkinga yokuphefumula uma ingakhali.
• Isikhumba esiluhlaza okwesibhakabhaka nezindebe (`i-Cyanosis`): Isikhumba somntwana, izindebe, kanye nezinzipho ziqala ukuphenduka zibe luhlaza okwesibhakabhaka ngoba umzimba awutholi umoya-mpilo owanele.
• Ukuphefumula kuphela uma ukhala: Njengoba ingane ivula umlomo wayo kuphela uma ikhala, iphefumula ngaleso sikhathi kuphela, futhi ubuluhlaza besikhumba buyehla bube bopinki. Lapho ukukhala kuphela, kuba nzima ukuphefumula futhi bese iphenduka ibe luhlaza okwesibhakabhaka.

Uma uhlangothi olulodwa lwekhala luvaliwe (i-Unilateral Choanal Atresia)

Ngenxa yokuthi lezi zimpawu azibonakali kangako, ungase ungaziboni kuze kube yilapho uletha ingane yakho ekhaya. Ungase ungaziboni ngisho naseminyakeni kamuva.

• Ukungaphumuli ngesikhathi uncelisa: Ingane idinga ukuphefumula ngekhala layo uma incelisa. Njengoba uhlangothi olulodwa luvalekile, kunzima ukuphefumula futhi ingane iyeka ukuncelisa bese ivula umlomo wayo. Lokhu kungenza ingane ingaphumuli futhi ingakwazi ukuncela kahle.
• Impumulo egobhozayo eqhubekayo ohlangothini olulodwa: Uma ikhala lomntwana wakho liqhubeka nokugobhoza ohlangothini olulodwa kuphela ngaphandle kwesizathu esibonakalayo, ngaphandle komkhuhlane, leso yisibonakaliso esiyinhloko nesivame kakhulu salesi simo.
• Ukucwila ngaphakathi uma ukhala:Uma ingane ingakhali, isifuba sibonakala sicwila njengoba ihluleka ukuphefumula.
• I-sinusitis engapheli: Izingane ezindala zingase zibe nokutheleleka kwe-sinus njalo ngenxa yokunqwabelana kwamafinyila ohlangothini olulodwa lwekhala.

Kungani lokhu kwenzeka? Iyini imbangela?

Imbangela eqondile yalesi simo ayikakaziwa okwamanje. Kodwa-ke, odokotela bakholelwa ukuthi ezigabeni zokuqala zokukhula komntwana esibelethweni, kuba nolwelwesi oluhlukanisa ikhala nomlomo. Ngokuvamile, lolu lwelwesi luyazincibilikisa lodwa njengoba umntwana ekhula. Kodwa-ke, kwezinye izingane, lolu lwelwesi luhlala futhi luhlala, olwaziwa ngokuthi i-'Choanal Atresia'.

Ezinye izimo ezihlobene

Cishe ingxenye yezingane ezine-Choanal Atresia zinezinye izifo zofuzo noma izinkinga zokuzalwa. Nakuba kungaziwa ukuthi kungani ngempela, lesi simo sivame ukwenzeka kanye nezinye izifo.

Phakathi kwazo, okulandelayo okubaluleke kakhulu:

• I-CHARGE syndrome: Cishe ama-60% ezinsana ezinezimbobo zombili zekhala zine-CHARGE syndrome.
• Isifo sikaTreacher Collins
• 'I-Crouzon syndrome'
• 'I-Pfeiffer syndrome'

I-Choanal Atresia ingabonakala nezinye izimo zofuzo ezifana nalezi. Ngakho-ke, udokotela uzohlola nalokhu.

Yiziphi izinkinga ezingaba khona uma zingelashwa?

Ikakhulukazi uma kukhona ukuvaleka kolunye uhlangothi, ukungazi ngakho kungabambezela ukwelashwa. Lokhu kungaba nemiphumela yesikhathi eside.

• Ukutheleleka kwendlebe okuvamile: Njengoba kukhona ukuxhumana phakathi kwekhala nendlebe, lapho uhlangothi olulodwa lwekhala luhlala luvalekile futhi lugcwele amafinyila, kungathinta indlebe futhi kubangele ukutheleleka kwendlebe okuvamile.
• Ukulahlekelwa ukuzwa: Ukutheleleka kwendlebe isikhathi eside kungalimaza indlebe futhi, ngokuhamba kwesikhathi, kubangele ukulahlekelwa ukuzwa.
• Ukufutha: Kukhona ingozi yokufutha ubisi noma ukudla kungene emgudwini womoya, ikakhulukazi ngenxa yobunzima bokuphefumula ngesikhathi uncelisa.

Ngenxa yalezi zingozi, udokotela uzoncoma ukwelashwa ngesikhathi esifanele kakhulu.

Ungasibona kanjani lesi simo?

Ingane enekhala elivalekile nhlangothi zombili ivame ukutholakala esibhedlela lapho izalwa. Kodwa-ke, uma kukhona ukuvaleka kolunye uhlangothi, kudingeka ukuhlolwa ukuze kutholakale ukuthi ikhona yini.

1. Ukuhlolwa kokuphefumula: Udokotela uzobamba ingilazi encane eduze kwekhala lomntwana bese ehlola ukuthi ingabe umusi uyaphuma yini kulo. Uma umusi ungaphumi ohlangothini olulodwa, kungase kubonise ukuthi kukhona ukuvaleka kulolo hlangothi.

2. Ukuskena kwe-CT:Yilokhu okwenza umehluko ngempela. Kufana nokuthatha isithombe se-3D sengaphakathi lekhala lakho. Lingabona ngokucacile ukuthi ukuvaleka kukuphi, kungakhathaliseki ukuthi yithambo noma ulwelwesi, nokuthi lujiyile kangakanani.

3. I-endoscopy yekhala: Le ndlela isebenzisa ithubhu enekhamera encane kakhulu efakwe ekhaleni futhi ivumela udokotela ukuthi abuke ingaphakathi lekhala ngqo esikrinini.

Ithimba lezokwelapha liqinisekisa ukuthi umntwana uphefumula kahle phakathi nalezi zivivinyo, ukuze kungabikho ingozi enganeni.

Iphathwa kanjani?

Ukwelashwa okuwukuphela kwaphakade kwe-Choanal Atresia ukuhlinzwa.

• Uma izinhlangothi zombili zekhala zivimbekile: Ingane izodinga ukuhlinzwa ngokushesha okukhulu.
• Uma uhlangothi olulodwa lwekhala luvalekile: Ngaphandle kokuthi ingane inezinkinga zokuphefumula noma zokudla ezinzima, udokotela angase anqume ukuhlehlisa ukuhlinzwa kuze kube yilapho ingane isikhulile kancane.

Ukuhlinzwa

Ukuhlinzwa kuhilela ukususa ithambo noma ulwelwesi oluvalekile nokulungisa kabusha indlela yokuphefumula ukuze ukuphefumula kuqhubeke. Lokhu kungenziwa ngekhala (transnasal) noma ngolwanga (transpalatal).

Kwezinye izimo, ipayipi elincane (i-`stent`) lifakwa ngendlela entsha ngemva kokuhlinzwa ukuze lingavaleki futhi. Leli payipi likhishwa futhi ngemva kwezinyanga ezimbalwa ngokuhlinzwa okuncane. Lokhu kuhlinzwa kwenziwa ngaphansi kwe-anesthesia ephelele, ukuze umntwana angazizwa ubuhlungu.

Ukuphathwa ekhaya

Uma ingane yakho inenkinga yokuvaleka kwesisu ohlangothini olulodwa futhi udokotela enquma ukuhlehlisa ukuhlinzwa, uzokunikeza imiyalelo yokuthi ungazilawula kanjani izimpawu ekhaya. Isibonelo, ungase utshelwe ukuthi usebenzise amaconsi e-saline ukuze ugcine ikhala licacile.

Imibuzo okufanele uyibuze udokotela wakho

Uma uthola ukuthi ingane yakho inalesi simo, kuyinto evamile ukuba nemibuzo eminingi engqondweni yakho. Ungesabi ukubuza le mibuzo kudokotela wakho.

• "Dokotela, ingabe ikhala lomntwana wami livalekile ohlangothini olulodwa noma zombili izinhlangothi?"
• "Ingabe lesi simo sihlobene nesinye isifo esifana ne-'CHARGE syndrome'?"
• "Ingane izohlinzwa nini?"
• "Udokotela uncoma uhlobo luni lokuhlinzwa?"
• "Singazi kanjani ukuthi ukuhlinzwa kuphumelele?"

Ukuthola ukuthi ingane yakho ine-Choanal Atresia, ikakhulukazi uma inenkinga yokuphefumula ngesikhathi izalwa, kungabathusa kakhulu abazali. Kodwa khumbula, lesi simo singelashwa ngempumelelo ngokuhlinzwa. Ngemva kokuhlinzwa, izingane eziningi ziyalulama ngokuphelele futhi ziphefumule ngaphandle kobunzima kukho konke ukuphila kwazo. Ngakho-ke, uma unesiqiniseko esincane sokuthi ingane yakho inalezi zimpawu, bheka udokotela ngokushesha ukuze ayohlolwa.